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Table 2 Comparison of policy options and implementation strategies in the policy brief versus the policy dialogue

From: Assessing the usefulness of policy brief and policy dialogue as knowledge translation tools towards contextualizing the accountability framework for routine immunization at a subnational level in Nigeria

No. Recommended policy options and implementation strategies in the policy brief Contextualized implementation strategies from the policy dialogue
1. Ensuring that the state cold store, the local government area (LGA) improvised cold stores and RI facilities’ cold chain equipment were adequate and fully functional
Strategy: Procurement and installation of solar panels, solar freezers and cold boxes
Pending the procurement and installation of more solar panels and deep freezers in LGAs and ward health centres, healthcare workers in the LGAs should optimize the use of available solar freezers in baking ice packs by removing and storing baked ice packs in cold boxes, thereby freeing space in the solar freezers for baking new ice packs
2. Ensuring adequate supply of vaccines bundled with auto–disable syringes and needles, and other commodities such as data tools, to all approved RI facilities statewide
Strategy: By the push method
LGAs to submit RI forecast data per antigen and accompanying protocols in a timely manner to the state headquarters to enable proper supply chain planning
3. Government should motivate skilled health workers, especially in the rural areas
Strategy: Through improved regular salaries and payment of rural posting allowances
Governments and communities should motivate health workers who have served well in the rural areas, especially through nonmonetary incentives. for example, communities could confer chieftaincy titles on health workers who have done well in their domain, government could nominate them for state and national awards, and commendation letters could be sent for such workers by the government and communities
4. Government should fund RI properly
Strategy: Through an increase in budgetary allocation and timely release of funds
The Federal Ministry of Health should produce a well-costed annual plan as a basis for evidence-based budgeting, since an evidence-based budget request can hardly be turned down
5. Government should increase the number of skilled health workers
Strategy: Recruit more skilled staff
In the interim, human resources for health in the state could be shored up by (i) encouraging volunteerism by mobilizing, incentivizing, training and using educated retired civil servants in their localities for RI services delivery, and (ii) by refraining from frequent transfers of skilled health workers away from the rural areas
6. Timeliness and completeness in data reporting Lack of power for charging phones and laptops and poor road networks hamper data reporting. Intersectoral collaboration between the ministries of health, power, works and information would positively affect RI service delivery. For instance, the Federal Ministry of Power could take over the supply and maintenance of solar panels and solar freezers to the LGA and ward health centres, and priority for road construction could be based on linking ward health centres to the LGA headquarters and state capital
7. Strengthening governance for RI accountability The stakeholder group involved in this policy dialogue should not disband but should transform into an independent accountability “watchdog” group that would advocate and ensure accountability in RI programmes
8. Institutionalization of sanctions and rewards The government, development partners, healthcare workers, civil society organizations and community members should have defined roles and responsibilities that will be complementary and integrated, and the discharge of such roles and responsibilities should be enforced